Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study

McCann, Caroline; Nazareth, D.; Walshaw, Martin

doi:10.1183/23120541.00343-2021

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…The real-time visual properties of DCR have been used to diagnose diaphragm dysfunction [ 30 ], as a form of low-dose fluoroscopy, in which paradoxical diaphragm motion can not only be observed but also quantified by computer assisted tracking of the diaphragm midpoint. Paradoxical diaphragm motion was clearly identified and agreed with the findings of either standard fluoroscopy or ultrasound.…”

Section: Resultsmentioning

confidence: 99%

Dynamic chest radiography: a state-of-the-art review

et al. 2023

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Dynamic chest radiography (DCR) is a real-time sequential high-resolution digital X-ray imaging system of the thorax in motion over the respiratory cycle, utilising pulsed image exposure and a larger field of view than fluoroscopy coupled with a low radiation dose, where post-acquisition image processing by computer algorithm automatically characterises the motion of thoracic structures. We conducted a systematic review of the literature and found 29 relevant publications describing its use in humans including the assessment of diaphragm and chest wall motion, measurement of pulmonary ventilation and perfusion, and the assessment of airway narrowing. Work is ongoing in several other areas including assessment of diaphragmatic paralysis. We assess the findings, methodology and limitations of DCR, and we discuss the current and future roles of this promising medical imaging technology.Critical relevance statement Dynamic chest radiography provides a wealth of clinical information, but further research is required to identify its clinical niche. Graphical abstract

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Section: Resultsmentioning

confidence: 99%

Dynamic chest radiography: a state-of-the-art review

et al. 2023

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“…Using automatic detection of visible lung borders in the posteroanterior (PA) projection,20 the projected lung area (PLA) can be traced during different breathing phases. This technology has already been applied to diaphragm motion analysis in healthy volunteers,21 suspected diaphragm palsy,22 chronic obstructive pulmonary disease23 24 and individuals taking CF transmembrane conductance regulator (CFTR)-modifying drugs 25. PLA has been shown to correlate well with vital capacity in healthy volunteers26 and those with interstitial lung disease,27 but to our knowledge, this relationship has not been explored in pwCF.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of dynamic chest radiography to calculate lung volumes in adult people with cystic fibrosis: a pilot study

et al. 2023

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IntroductionDynamic chest radiography (DCR) is a novel, low-dose, real-time digital imaging system where software identifies moving thoracic structures and can automatically calculate lung areas. In an observational, prospective, non-controlled, single-centre pilot study, we compared it with whole-body plethysmography (WBP) in the measurement of lung volume subdivisions in people with cystic fibrosis (pwCF).MethodsLung volume subdivisions were estimated by DCR using projected lung area (PLA) during deep inspiration, tidal breathing and full expiration, and compared with same-day WBP in 20 adult pwCF attending routine review. Linear regression models to predict lung volumes from PLA were developed.ResultsTotal lung area (PLA at maximum inspiration) correlated with total lung capacity (TLC) (r=0.78, p<0.001), functional residual lung area with functional residual capacity (FRC) (r=0.91, p<0.001), residual lung area with residual volume (RV) (r=0.82, p=0.001) and inspiratory lung area with inspiratory capacity (r=0.72, p=0.001). Despite the small sample size, accurate models were developed for predicting TLC, RV and FRC.ConclusionDCR is a promising new technology that can be used to estimate lung volume subdivisions. Plausible correlations between plethysmographic lung volumes and DCR lung areas were identified. Further studies are needed to build on this exploratory work in both pwCF and individuals without CF.Trial registration numberISRCTN64994816.

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“…Prior to automated image analysis, these breath-hold inspiratory images are similar to a chest film and can be used for this purpose. DCR can also be used to calculate lung volume subdivisions ( 12 ), assess diaphragm motion ( 13 , 14 ), measure ventilation ( 15 ) and quantify lung nodule motion ( 16 ). These attributes may afford it a role as a thoracic imaging technique in the workup of individuals with lung cancer.…”

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confidence: 99%